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Coblation-assisted Lewis and MacKay operation (CobLAMO): new technique for tongue reduction in sleep apnoea surgery

Published online by Cambridge University Press:  19 November 2013

S G MacKay ,
N Jefferson ,
L Grundy  and
R Lewis
S G MacKay*
Affiliation:
Department of Otolaryngology Head Neck Surgery, The Wollongong Hospital, Australia Graduate School of Medicine, University of Wollongong, Australia
N Jefferson
Affiliation:
Department of Otolaryngology Head Neck Surgery, The Wollongong Hospital, Australia
L Grundy
Affiliation:
Department of Anaesthesia, The Wollongong Hospitaland, Australia
R Lewis
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Royal Perth Hospital, Australia
*
Address for correspondence: A/Prof Stuart MacKay, 1–2, 8–10 Victoria St, Wollongong, NSW, Australia2500 Fax: +61 2 4227 6292 E-mail: sgmackay@ozemail.com.au
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Abstract

Background:

Obstructive sleep apnoea is a common condition that is unfortunately associated with a high rate of patient non-compliance regarding device use. Newer surgical interventions have focused on procedures at the palate level, using variants of palatoplasty and transpalatal advancement. However, the extent of tongue reduction surgery required remains controversial. The authors propose an in-between variant that combines midline glossectomy resection (with minimal mucosal sacrifice) and lateral coblation tongue channelling.

Method:

Four patients underwent a coblation-assisted Lewis and MacKay operation, which is a new technique for tongue reduction. This involved a midline glossectomy combined with lateral coblation channelling of the tongue, alone or as part of major airway reconstruction. Demographic, polysomnographic and quality of life questionnaire data were collected prospectively and analysed.

Results and conclusion:

No significant complications were noted in the four patients. (Results of the post-surgical outcomes are presented in another paper.) The coblation-assisted Lewis and MacKay operation reduced the potential complications of aggressive tongue surgery. The contours of the tongue were maintained, but significant reduction was still achieved.

Keywords

Obstructive Sleep ApneaQuality of LifeQuestionnairesSnoringReconstructive Surgical Procedures
Type
Short Communications
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 12 , December 2013 , pp. 1222 - 1225
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Weaver, TE, Grunstein, RR. Adherence to continuous positive airway pressure therapy: the challenge to effective treatment. Proc Am Thorac Soc 2008;5:173–8CrossRefGoogle ScholarPubMed
2Mackay, SG, Carney, AS, Woods, C, Antic, NA, McEvoy, RD, Chia, M et al. Modified uvulopalatopharyngoplasty and coblation channeling of the tongue for obstructive sleep apnea: a multi-centre Australian trial. J Clin Sleep Med 2013;9:117–24CrossRefGoogle ScholarPubMed
3Fairbanks, DNF, Mickelson, SA, Woodson, BT. Snoring and Obstructive Sleep Apnea, 3rd edn.Philadelphia: Lippincott Williams and Williams, 2003;160–6Google Scholar
4Zhang, Q, Song, W, She, C, Liu, D, Li, D, Zhang, X et al. Coblation-assisting uvulopalatopharyngoplasty combining coblation-channeling of the tongue for patients with severe OSAHS [in Chinese]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012;26:114–17Google ScholarPubMed
5Robinson, S, Krishnan, S, Hodge, JC, Foreman, A. Conventional tongue base volumetric reduction for obstructive sleep apnea. Operative Techniques in Otolaryngology 2012;23:36–44CrossRefGoogle Scholar
6MacKay, SG, Jefferson, ND, Marshall, NS. Beyond uvulopalatopharyngoplasty for obstructive sleep apnoea: single surgeon case series of contemporary airway reconstruction. J Laryngol Otol In pressGoogle Scholar